Capital Blue Cross coverage policies

223 active Capital Blue Cross policies in Backwork, grouped by policy type. Each policy page shows the codes the policy lists and links to the payer’s own copy.

Summary of the payer’s published policy. Not a coverage determination — confirm with Capital Blue Cross before submitting.

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Policies

151–200 of 223, by type and title

PayerPolicy

CAPBLUE-MP-2.085

Optical Coherence Tomography (OCT) of the Anterior Eye Segment

CAPBLUE-MP-2.383

Orphan Drugs and Humanitarian Use Devices

CAPBLUE-MP-4.039

Orthopedic Applications of Platelet Rich Plasma

CAPBLUE-MP-2.080

Orthopedic Applications of Stem Cell Therapy (Including Allograft and Bone Substitute Products Used with Autologous Bone Marrow)

CAPBLUE-MP-2.005

Other Therapies of Hyperhidrosis

CAPBLUE-MP-2.097

Paraspinal Surface Electromyography to Evaluate and Monitor Back Pain

CAPBLUE-MP-6.024

Pelvic Floor Stimulation as a Treatment of Urinary and Fecal Incontinence

CAPBLUE-MP-2.397

Percutaneous Electrical Nerve Field Stimulation for Irritable Bowel Syndrome

CAPBLUE-MP-6.050

Percutaneous Electrical Nerve Stimulation (PENs) and Percutaneous Neuromodulation Therapy (PNT)

CAPBLUE-MP-1.141

Peripheral Subcutaneous Field Stimulation (PSFS)

CAPBLUE-MP-1.109